Active NPI
Livevital Physical Therapy & Performance
- Physical Therapist
- Portland, ME
National Provider Identifier
1417288747
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- Legal business name
- LIVEVITAL PHYSICAL THERAPY & PERFORMANCE
- Practice address
- 40 Maple Street
Portland, ME 04101 - Phone
- (207) 749-0617
- NPI assigned
- Jan 27, 2010
- Last updated
- Jan 27, 2010
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- David T Knop, PT
- Title
- Owner/President
- Phone
- (207) 749-0617
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | Primary |
Addresses
Primary practice location
40 Maple Street
Portland, ME 04101
Mailing address
40 Maple Street
Portland, ME 04101
Phone (207) 749-0617
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in ME
Enrollment records 1
National Provider Directory
National Provider DirectoryLocations
40 Maple St
Portland, ME 04101
Phone (207) 749-0617
Practitioners & affiliated clinicians
Practitioners 4
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Physical Therapist
- Portland, ME
- NPI 1497755227
-
- Physical Therapist
- South Portland, ME
- NPI 1609224765
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1264550400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1264550400000",
"number": "1417288747",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "40 MAPLE STREET",
"city": "PORTLAND",
"state": "ME",
"postal_code": "04101",
"telephone_number": "207-749-0617"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "40 MAPLE STREET",
"city": "PORTLAND",
"state": "ME",
"postal_code": "04101",
"telephone_number": "207-749-0617"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "LIVEVITAL PHYSICAL THERAPY & PERFORMANCE",
"organizational_subpart": "NO",
"enumeration_date": "2010-01-27",
"last_updated": "2010-01-27",
"status": "A",
"authorized_official_last_name": "KNOP",
"authorized_official_first_name": "DAVID",
"authorized_official_middle_name": "T",
"authorized_official_title_or_position": "OWNER/PRESIDENT",
"authorized_official_telephone_number": "207-749-0617",
"authorized_official_credential": "PT"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Physical Therapist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Portland, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.